The American Society of Reproductive Medicine, Oct. 28- Nov. 1

The annual meeting of the American Society for Reproductive Medicine was held from Oct. 28 to Nov. 1 in San Antonio and attracted approximately 5,000 participants from around the world, including physicians, researchers, nurses, technicians, and other health care professionals focused on reproductive medicine. The conference featured more than 1,000 abstracts that focused on reproductive biology and more than 200 vendors.

In one study, Pietro Bortoletto, M.D., of Brigham and Women's Hospital and Massachusetts General Hospital in Boston, and colleagues evaluated the perceptions and attitudes of reproductive endocrinologists and gynecologic surgeons who perform minimally invasive procedures about uterine transplantation.

"We sent a 28-question online survey to over 400 members of the American Society for Reproductive Medicine as well as members of the American Association of Gynecologic Laparoscopists. As a whole, 79 percent supported women being able to donate or receive a transplanted uterus," said Bortoletto."Their most common concern with uterine transplantation were the risks associated to the donor (72.7 percent), recipient (51.5 percent), and 56 percent for the infants being born from the transplanted uterus."

The majority (71 percent) of respondents supported uterine transplantation as an ethical surgical procedure; however, only 42.5 percent agreed that it should be considered a potential treatment option for patients with absolute uterine factor infertility.

"Our study demonstrates that a majority of American gynecologists surveyed find uterine transplantation to be an acceptable and ethical treatment option that should be available to patients," said Bortoletto. "As of March 2017, five transplants have taken place in the U.S.; however, four have been removed because of complications. As there are more successful uterus transplants, there is likely to be even greater support for this innovative technique."

Eduardo Hariton, M.D., of Brigham and Women's Hospital and Massachusetts General Hospital in Boston, and colleagues found that the majority of survey respondents in a nationally representative sample of U.S. residents support uterine transplantation, find it ethical, and believe it is an acceptable alternative to a gestational carrier.

"The ethical aspects and clinical value of uterine transplantation have been controversial. Our objective was to evaluate opinions and attitudes of the general public regarding uterine transplantation in the U.S.," said Hariton.

The investigators sampled a nationally representative group of adult U.S. residents who completed an online questionnaire. The final analysis included 1,247 respondents. The researchers found that 78 percent supported and 4 percent opposed allowing women to undergo uterine transplantation; the remainder were neutral. In addition, two-thirds of respondents found uterine transplantation ethical and also found it to be an acceptable alternative to gestational carriers.

"Respondents' biggest concern regarding uterine transplantation was the safety of the procedure for donors, recipients, and babies," said Hariton. "As a whole, however, the U.S. public is in favor of uterine transplantation as a treatment for uterine-factor infertility."

In another study, Eleni Greenwood, M.D., of the University of California at San Francisco, and colleagues evaluated risk factors for depression among 737 women with polycystic ovary syndrome (PCOS). The investigators found that insulin resistance doubles the risk of depression in women with PCOS.

"Insulin resistance, as measured by HOMA-IR greater than 2.2, was associated with two times increased odds of depression, after controlling for potential confounders," said Greenwood.

Higher levels of anti-mullerian hormone reduced the odds of depression. However, this association was no longer significant in a multivariate model controlling for confounders.

"The next step is to demonstrate whether treating insulin resistance will improve mood in depressed women with PCOS. We are planning a clinical trial to investigate this question, with the hopes of identifying a novel targeted therapeutic option," said Greenwood.

Marc J. Rogers, M.D., of the Medical University of South Carolina in Charleston, and colleagues evaluated the impact of marijuana use on male reproductive health.

"It is estimated that 22 percent of adults have used marijuana, with a large portion of the users being men of reproductive age. Recent reports indicated that marijuana can have a negative impact overall on a man's fertility potential. However, this data is limited and needs to be expanded upon in order to improve patient care," said Rogers.

He notes that there are only three published clinical studies about the effects of marijuana consumption on fertility.

"In this limited data, neither dosing nor frequency of marijuana usage was controlled, but each of the three studies indicated a worsening of semen parameters. The studies indicated that concentration, motility, and morphology could be affected by marijuana consumption," said Rogers. "At this time, we would counsel men with infertility to cease marijuana usage due to potentially negative impacts. On a larger scale, it is important the fertility field pursues clinical studies in this area to provide better data when counseling marijuana users experiencing fertility issues."